28D2195200 CLIA NUMBER - REGION 1 OFFICE OF HUMAN DEVELOPMENT

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Laboratory Demographics

CLIA Number: 28D2195200

Facility Name: REGION 1 OFFICE OF HUMAN DEVELOPMENT

Facility Address:
2603 CIRCLE DRIVE
SCOTTSBLUFF, NE
ZIP 69361
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Facility Phone Number: 308 635-3444

Facility Type: Intermediate Care Facility for Mentally Retarded

Certificate Type: Waiver

NPI Number: 1689217150

Taxonomy: 261QD1600X - Clinic/Center
An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).

CLIA Record

Field Name	Field Value
CLIA Number	28D2195200
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	REGION 1 OFFICE OF HUMAN DEVELOPMENT
Street	2603 CIRCLE DRIVE
City	SCOTTSBLUFF
State	NE
ZIP	69361
Phone	308 635-3444
CertificateType	4
CertificateEffectiveDate	10/7/2022
CertificateExpirationDate	10/6/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024